Oral Cancer Screening

Oral cancer doesn’t get as much attention as some other types of cancer, but it is just as deadly. Early diagnosis and treatment are key.


Screening involves examining the mouth for any sores, white patches (leukoplakia) or lumps. It is usually performed by a dentist or doctor.

Research has found that visual inspection is a feasible model for screening oral cancer and OPMDs with acceptable diagnostic accuracy.

Early Detection

Many pre-cancers and early oral cancers can be found in their earliest stages when they are easy to treat. Oral cancer screening allows healthcare professionals to examine the whole mouth, including the cheeks, lips, tongue, jaw, and inside of the nose for asymmetries, lumps, sores, patches of color, and other abnormalities that could be signs of cancer. They may also use a special tool, like toluidine blue dye, that coats anything that looks suspicious and helps identify areas that might be a cancerous lesion. If a spot is found, the healthcare provider can take a small tissue sample for biopsy or recommend a imaging test like a CT scan, an MRI, or a PET scan to get a more detailed picture of the area.

Some studies suggest that a combination of visual examination (VOE) and other tests such as HPV testing or cytology improves the detection of oral cancer. There are also several models for screening, such as population-based screening with invitations to attend a screening event, opportunistic screening in dental practices or hospitals, integrating oral cancer screening into general health checks, and telemedicine for consultation with specialists.

The USPSTF recommends that primary care providers (PCPs) routinely screen asymptomatic adults for oral cancer with visual inspection and simple HPV testing. It is important that the screening program has high attendance rates, proper training for PHCWs in conducting VOE, and a referral pathway to ensure that a cancer or pre-cancer is promptly detected and treated.

Less Risk

The primary screening test for oral cancer is a visual inspection of the mouth and neck (including the tonsils). Healthcare providers may use their fingers to feel for lumps and bumps, or coat areas with a special dye called toluidine blue. The dye highlights any area that might be a pre-cancerous or cancerous lesion.

If a suspicious area is detected, a tissue biopsy can be performed to determine whether the abnormal cells are pre-cancerous or cancerous. However, it is important to note that no study has yet reported harms from the detection or treatment of screen-detected oral cancer or its precursors. Moreover, because of the rapid natural history of screen-detected oral cancer and its precursors, they are unlikely to cause significant mortality or morbidity in their own right.

The US Preventive Services Task Force (USPSTF) recommends that everyone above the age of 40 should get screened for oral cancer annually with a visual and tactile examination. People in high risk groups, such as adults who smoke or chew tobacco, heavy alcohol users and those with the sexually transmitted human papillomavirus (HPV) should be screened more frequently.

Less Pain

Oral cancer isn’t a common type of cancer, but that doesn’t make it any less deadly. It can still kill someone every hour of every day, and many cases are diagnosed at an advanced stage when they’re much more difficult to treat. This is due to late detection, which could be avoided with routine screenings by dentists.

While many people do a self-exam at home, the truth is that most pre-cancerous and cancerous spots aren’t noticeable to the naked eye until they begin growing or changing shape. A simple oral cancer screen can catch these changes, however, and they don’t take much time out of your regular dental visits unless you specifically book an appointment for one.

Your dentist may also use technological tools to help with the screening process, such as a VELscope, which shines a safe blue light into your mouth. This illuminates any normal tissue, while cancerous or pre-cancerous cells will appear dark. This can make spotting these areas easier and more accurate.

While the risk of oral cancer increases with age, screening should start as early as your teens. It’s recommended to have a screen at least once a year, and you should definitely get one if you smoke or drink heavily. This will reduce your chances of getting an advanced oral cancer, and it’s the best way to save your life.

More Options

Regular oral cancer screenings increase the chance that any abnormal tissue can be removed before it has a chance to spread. It’s also a good idea for people who suspect they may have cancer to get regularly screenings, especially if they have risk factors like smoking or drinking alcohol. Screenings are quick and painless, and can usually be completed in less than five minutes.

While a visual examination is one of the main aspects of a screening, some dentists and dental hygienists use additional methods. One method involves using a small tool called a VELscope(r), which projects blue light inside the mouth and makes it easier to see areas of concern. The light reacts with a special dye in the tissue, making any lesions stand out much more clearly.

In addition to the tongue, gums, lips, and cheek lining, an oral cancer screening can also include the roof of the mouth, the tonsils, the pharynx (which extends into the throat), and other areas. In some cases, your dentist or hygienist might even evaluate the face and neck, pressing on your ears or looking for lumps in the throat area.

While medical organizations don’t agree on whether or not routine oral exams and cancer screenings are proven to save lives, they do acknowledge that they help find tumors and precancerous lesions in early stages when they are more easily treated. With a better chance of being cured, an oral cancer screening is well worth the extra time.